About a year ago I began forwarding all my work e-mail to my GMail account. I did this for archiving purposes (unlimited e-mail rather than the 100 MB inbox my company’s Microsoft Exchange server allows), for quick searches (it takes too long to find an old message in Microsoft Outlook) and because the user interface provides threading of messages (also missing in Outlook).
What I really did not expect is the advantage of the advertisements. These appear at the top and to the right of each of my work messages and their targeting is based on the words in my messages.
This turned out to be one of the best ways to find innovative startups. For example, I am part of the research team working on data warehouses and we know that the extract / transform / load (ETL) process is a painful one. We all searched around for tools that help CIOs deal with this problem, but only I had an advert around their messages about data warehousing.
Advertising on GMail – not a bug, but a feature.
Here are some interesting data about internet advertising spending per capita: the UK spends the most, at $213 per year per person, vs. the USA, fourth at $132.
I got this from a TechCrunch article evaluating the true value of social networks, and find it useful as I create a business plan for my new company, based in the UK and advertising-supported. The UK’s lead is reflective of a more mature market. South Kore and Japan may lead in broadband deployments and the USA may lead in venture capital spending but the UK market’s ability to monetize new media has impressed me ever since BSkyB began using Google for its television advertising platform back in the 2006.
This is a fabulous pre-print paper from JAMIA (PDF) that sums up the issues perfectly. Bar code medication administration (BCMA) does help with patient safety, more so than computerised physician order entry (CPOE) does, and at a fraction of the price and headaches. But it is still costly and it causes headaches for the nurses.
The headaches appear as workarounds: things nurses do to avoid the pain of BCMA.
Hospital CIOs have to pay attention to workarounds to improve patient safety – by maintaining the workflow of BCMA – but also to help the nurses – they are too busy to complain when the system is not working.
Table 1 in the paper is well worth reading as it summarizes the workarounds:
Omission of process steps
- User scans medication from patient drawer without visual check of medication list, medication name and dose.
- Physicians do not review electronic medication administration record to verify current medications.
- User administers medication without reviewing parameters for medication administration.
- Users bypass policy for “medication double check” by second provider, or second nurse confirms without reviewing medications.
- User does not check / verify patient’s new medication orders before administering medication.
- User administers medication without scanning patient ID to confirm correct patient.
- User administers medication without scanning barcode to confirm it is correct medication, time, dose.
- User documents medication administration before medication is administered and / or observed ingested by patient
- Patient barcode placed on another object (not patient) and user scans it.
- User prepares, scans and transports medications for > 1 patient at a time when administering medications.
- User scans barcode after barcode label has been removed from the medication itself.
- User has multiple medication packages for full dose and scans the same medication package multiple times.
- User takes the scanner separate from the cart into the room where the cart alarm cannot be seen.
- User gives partial dose but electronically documents full dose.
- User disables audio alarms on device.
It has only been 24 hours since Apple announced their new iPhone 3G and already doctors are asking me questions like this one:
I was wondering what is your take on the new iphone 3G? I am in Australia and with the 3 network so dont know if I am able to buy this phone and have it be compatible as yet. I was never going to consider the iphone but this new one seems good, however I am still unsure if the apple interface is capable of running all the applications doctors use such as those from skyscape eg 5MCC etc…
My answer: yes. There is only one reason not to like the iPhone and that is the keyboard. Not everyone will be able to write very much with it. So if you are thinking of sending lots of e-mail messages or taking lecture notes then try out the keyboard in the shops before you buy.
Otherwise, you should definitely buy this. Every singe medical publisher I have spoken to, including Epocrates, is making iPhone-specific versions of their software and content. Others are making content that is only possible with the iPhone's technology. And the built-in WiFi and 3G connectivity make this the perfect device for answering clinical questions while at the patient's bedside.
So think of this as a clinical tool and buy it.